What's going on: 'Gorgeous Gabby' sheds helmet after skull surgery

(AP Photo/David J. Phillip)Dr. Dong Kim discusses the size of the implant he placed on U.S. Rep. Gabrielle Giffords' skull, during a news conference to update Giffords' condition Thursday, May 19, 2011, in Houston. Physicians on Wednesday put a plastic implant in place to fully cover her brain.

HOUSTON (AP) — Rep. Gabrielle Giffords' new look without a helmet has earned her another nickname.

"I started calling her Gorgeous Gabby today," neurosurgeon Dr. Dong Kim said Thursday, a day after performing the successful surgery to repair her skull.

The helmet adorned with the Arizona state flag that Giffords has worn since she was shot in the head in January is finally gone.

When Giffords was wounded, doctors removed a piece of her skull to allow her brain to swell, and she wore the helmet for protection.

During Wednesday's surgery, the missing bone was replaced with a piece of molded hard plastic with tiny screws. Doctors said that her skull will eventually fuse with the plastic's porous material.

Dr. Gerard Francisco, head of Giffords' rehabilitation team at TIRR Memorial Hermann hospital in Houston, said the surgery will allow doctors to "upgrade" her therapy, possibly improving her rate of recovery.

"She hasn't looked in the mirror yet, but as soon as she does she'll be very pleased," Kim said.

Even shaving her head to prevent infection hasn't harmed her appearance, Kim said.

"I think it looks quite cute if you ask me, and hair will grow back," he added.

Giffords' astronaut husband, Mark Kelly, is in space and couldn't see her. But he closely followed the intricate, 3½-hour surgery, talking to his brother and mother-in-law by Internet phone on the International Space Station and emailing doctors.

"She's doing really, really well, as good as possibly could be expected," Kelly said in interview from space.

Kelly said he's "looking forward" to her release from TIRR, though no one, including her doctors, is saying when that will be.

Still, the operation is considered a major milestone in her recovery, and doctors said they worked according to their original plan, performing the surgery at an optimal time and not rearranging it to fit Kelly's launch schedule.

Just removing the helmet will help her recovery.

Experts say it can be cumbersome during therapy. Losing the helmet can have a positive psychological impact, boosting the patient's confidence from looking healthy again.

Giffords' chief of staff Pia Carusone said "5/17/11" was scrawled on the helmet as a reminder of the last day she would have to don the headgear.

"She hates the helmet," Carusone said, noting that Giffords was excited before the operation. "She's been looking forward to this for a while."

A would-be assassin shot Giffords at a political event in her hometown of Tucson, Ariz. The rampage left six dead and 13 injured, including the Arizona Democrat.

During surgery, Giffords also had a permanent shunt placed under the skin behind her ear to drain spinal fluid from her brain and into her abdomen, Kim said. It will relieve pressure from fluids that often build up in patients with a brain injury.

The shunt is not visible and many patients forget they have one, doctors said.

Doctors said the buildup of spinal cord fluid in her brain could have created pressure on the organ, impairing some cognitive functions.

Dr. Richard Riggs, chair of physical medicine and rehabilitation at Cedars-Sinai Medical Center in Los Angeles, said relieving the pressure by draining the fluids could help her do more complex tasks and higher-level cognitive activities.

"They may have an uptick in performance afterward," he said.

In rehab, therapists try to get the patient "as independent as they can so they can be at home," Riggs said.

Giffords' lengthy inpatient rehabilitation — which began in late January — is also unusual, especially since she made two successful out-of-state trips to watch her husband's launch, an indication she can likely function at home, he said.

As expected, she had some pain and nausea shortly after Wednesday's surgery, but a scan of her brain showed the operation was successful, Kim said.

The surgery carries a small risk of infection, Kim said, and doctors will monitor Giffords for any signs of that in the coming weeks. There are still some remaining bullet fragments in Giffords' brain that will not be removed because doing so could make her condition worse, he said.